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Applying the Intention-Action Framework to Specialty Referrals
Sponsor: University of California, Los Angeles
Summary
This is a prospective randomized controlled trial evaluating an EHR-embedded behavioral intervention intended to reduce low-value specialty referrals in cardiology, pulmonology, and gastroenterology. The intervention is designed to (1) strengthen physicians' intentions to avoid low-value specialty referrals at the point of encounter by presenting criteria for high-value referrals and informing physicians that referral decisions may be reviewed and (2) support follow-through on these intentions by modifying the referral process through structured checklist prompts embedded within the referral workflow. The primary hypothesis is that physicians exposed to the intervention will demonstrate lower rates of low-value cardiology, pulmonology, and gastroenterology referrals compared with physicians exposed to the arm where the order composer allows physicians to place referrals with minimal decision support.
Official title: Reducing Low-Value Care: Applying the Intention-Action Framework to Specialty Referrals
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
1600
Start Date
2026-07-01
Completion Date
2027-01-31
Last Updated
2026-06-26
Healthy Volunteers
No
Conditions
Interventions
Information provision
The order composer displays high-value criteria developed by UCLA Health using professional society guidelines and expert consensus from clinical leadership.
Auditing
The order composer notifies physicians that their referral decisions may be subject to review.
Checklist
The order composer includes cascading checkboxes that prompt physicians to confirm that referral criteria are met before submitting a referral. Physicians must actively indicate whether the patient meets referral criteria before submitting a referral. Physicians who determine that a referral remains clinically appropriate despite the patient not meeting listed criteria may select an option indicating that none of the listed criteria apply and provide a brief free-text explanation for proceeding with the referral.
Locations (1)
UCLA Health Department of Medicine
Los Angeles, California, United States